Intensive Care Medicine

, Volume 36, Issue 8, pp 1386–1393 | Cite as

Gastric residual volume during enteral nutrition in ICU patients: the REGANE study

  • J. C. Montejo
  • E. Miñambres
  • L. Bordejé
  • A. Mesejo
  • J. Acosta
  • A. Heras
  • M. Ferré
  • F. Fernandez-Ortega
  • C. I. Vaquerizo
  • R. Manzanedo
Original

Abstract

Objective

To compare the effects of increasing the limit for gastric residual volume (GRV) in the adequacy of enteral nutrition. Frequency of gastrointestinal complications and outcome variables were secondary goals.

Design

An open, prospective, randomized study.

Setting

Twenty-eight intensive care units in Spain.

Patients

Three hundred twenty-nine intubated and mechanically ventilated adult patients with enteral nutrition (EN).

Interventions

EN was administered by nasogastric tube. A protocol for management of EN-related gastrointestinal complications was used. Patients were randomized to be included in a control (GRV = 200 ml) or in study group (GRV = 500 ml).

Measurements and results

Diet volume ratio (diet received/diet prescribed), incidence of gastrointestinal complications, ICU-acquired pneumonia, days on mechanical ventilation and ICU length of stay were the study variables.

Gastrointestinal complications were higher in the control group (63.6 vs. 47.8%, P = 0.004), but the only difference was in the frequency of high GRV (42.4 vs. 26.8%, P = 0.003). The diet volume ratio was higher for the study group only during the 1st week (84.48 vs. 88.20%) (P = 0.0002). Volume ratio was similar for both groups in weeks 3 and 4. Duration of mechanical ventilation, ICU length of stay or frequency of pneumonia were similar.

Conclusions

Diet volume ratio of mechanically ventilated patients treated with enteral nutrition is not affected by increasing the limit in GRV. A limit of 500 ml is not associated with adverse effects in gastrointestinal complications or in outcome variables. A value of 500 ml can be equally recommended as a normal limit for GRV.

Keywords

Enteral nutrition Gastric residual volume Mechanical ventilation Ventilator-associated pneumonia Intensive care unit 

Notes

Acknowledgments

We thank Nestle Nutrition (Spain) for their financial support for the statistical analysis. Thanks also to the members of the SEMICYUC Metabolic and Nutritional Working Group, Spain, for their participation in this multicenter study.

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Copyright information

© Copyright jointly held by Springer and ESICM 2010

Authors and Affiliations

  • J. C. Montejo
    • 1
  • E. Miñambres
    • 2
  • L. Bordejé
    • 3
  • A. Mesejo
    • 4
  • J. Acosta
    • 5
  • A. Heras
    • 6
  • M. Ferré
    • 7
  • F. Fernandez-Ortega
    • 8
  • C. I. Vaquerizo
    • 9
  • R. Manzanedo
    • 10
  1. 1.Medicina Intensiva, Unidad Polivalente, ICUHospital Universitario 12 de OctubreMadridSpain
  2. 2.ICUHospital Universitario Marqués de ValdecillaSantanderSpain
  3. 3.ICUHospital Universitari Germans Trias i PujolBadalonaSpain
  4. 4.ICUHospital Clínico Universitario de ValenciaValenciaSpain
  5. 5.ICUHospital General Universitario de AlicanteAlicanteSpain
  6. 6.ICUHospital General de Castelló de La PlanaCastellón de la PlanaSpain
  7. 7.ICUHospital Vall d’HebronBarcelonaSpain
  8. 8.ICUHospital Carlos HayaMalagaSpain
  9. 9.ICUHospital Universitario de FuenlabradaFuenlabradaMadrid
  10. 10.ICUHospital Universitario de Gran Canaria Dr. NegrinLas Palmas de Gran CanariaSpain

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